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Low iris and anterior chamber volume is associated with deepening after laser peripheral iridotomy in primary angle closure suspects

  • Glaucoma
  • Published:
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Abstract

Purpose

To evaluate the association between baseline ocular variables and the widening of the anterior chamber angle by laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS) using a new Fourier-domain swept-source anterior segment optical coherence tomography (FD-ASOCT).

Method

Sixty-six PACS eyes of 41 individuals were enrolled in this prospective interventional case series. An FD-ASOCT (Casia SS-1000 OCT; Tomey, Nagoya, Japan) was used to measure biometric baseline variables and at 1 month after the LPI. Paired t test was used to compare the difference between pre-and post-LPI measurements. Multivariate regression analysis was used to test for an association between baseline iris thickness and volume, anterior chamber depth and volume, and lens vault with a widening of the angle after an LPI. Changes in trabecular iris space area and angle opening distance after the LPI were main outcome measures.

Results

The mean age of participants was 58.6 ± 8.7 years, 68.2% of whom were female. The angle opening distance, recess area, and trabecular iris surface area at 500 μm increased by 48 to 73% (all P < 0.001). Lens vault and iris volume did not change. A low anterior chamber volume and low iris volume were associated with angle greater deepening by LPI.

Conclusion

Eyes with a shallow anterior chamber and thinner irises are more likely to experience angle opening from an LPI.

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References

  1. Sun X, Dai Y, Chen Y et al (2017) Primary angle closure glaucoma: what we know and what we don’t know. Prog Retin Eye Res 57:26–45

    Article  Google Scholar 

  2. Tham Y-C, Li X, Wong TY et al (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121:2081–2090

    Article  Google Scholar 

  3. Pakravan M, Yazdani S, Javadi M-A et al (2013) A population-based survey of the prevalence and types of glaucoma in Central Iran: the Yazd eye study. Ophthalmology 120:1977–1984

    Article  Google Scholar 

  4. Lowe RF (1970) Aetiology of the anatomical basis for primary angle-closure glaucoma. Biometrical comparisons between normal eyes and eyes with primary angle-closure glaucoma. Br J Ophthalmol 54:161–169

    Article  CAS  Google Scholar 

  5. Lee DA, Brubaker RF, Ilstrup DM (1984) Anterior chamber dimensions in patients with narrow angles and angle-closure glaucoma. Arch Ophthalmol 102:46–50

    Article  CAS  Google Scholar 

  6. Marchini G, Pagliarusco A, Toscano A et al (1998) Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle-closure glaucoma. Ophthalmology 105:2091–2098

    Article  CAS  Google Scholar 

  7. Tarongoy P, Ho CL, Walton DS (2009) Angle-closure glaucoma: the role of the lens in the pathogenesis, prevention, and treatment. Surv Ophthalmol 54:211–225

    Article  Google Scholar 

  8. Wang N, Ouyang J, Zhou W et al (2000) [Multiple patterns of angle closure mechanisms in primary angle closure glaucoma in Chinese]. Zhonghua Yan Ke Za Zhi 36:46–51 5, 6

    PubMed  Google Scholar 

  9. Congdon NG, Youlin Q, Quigley H et al (1997) Biometry and primary angle-closure glaucoma among Chinese, white, and black populations. Ophthalmology 104:1489–1495

    Article  CAS  Google Scholar 

  10. Nongpiur ME, He M, Amerasinghe N et al (2011) Lens vault, thickness, and position in Chinese subjects with angle closure. Ophthalmology 118:474–479

    Article  Google Scholar 

  11. Thomas R, George R, Parikh R et al (2003) Five year risk of progression of primary angle closure suspects to primary angle closure: a population based study. Br J Ophthalmol 87:450–454

    Article  CAS  Google Scholar 

  12. Schwartz LW, Rodrigues MM, Spaeth GL et al (1978) Argon laser iridotomy in the treatment of patients with primary angle-closure or pupillary block glaucoma: a clinicopathologic study. Ophthalmology 85:294–309

    Article  CAS  Google Scholar 

  13. Lei K, Wang N, Wang L, Wang B (2007) Morphological changes of the anterior segment after laser peripheral iridotomy in primary angle closure. Eye 23:345–350

    Article  Google Scholar 

  14. McGalliard JN, Wishart PK (1990) The effect of Nd:YAG iridotomy on intraocular pressure in hypertensive eyes with shallow anterior chambers. Eye 4(Pt 6):823–829

    Article  Google Scholar 

  15. Dada T, Mohan S, Sihota R et al (2007) Comparison of ultrasound biomicroscopic parameters after laser iridotomy in eyes with primary angle closure and primary angle closure glaucoma. Eye 21:956–961

    Article  CAS  Google Scholar 

  16. He M, Friedman DS, Ge J et al (2007) Laser peripheral iridotomy in eyes with narrow drainage angles: ultrasound biomicroscopy outcomes. The Liwan Eye Study. Ophthalmology 114:1513–1519

    Article  Google Scholar 

  17. Yao B-Q, Wu L-L, Zhang C, Wang X (2009) Ultrasound biomicroscopic features associated with angle closure in fellow eyes of acute primary angle closure after laser iridotomy. Ophthalmology 116:444–448.e2

    Article  Google Scholar 

  18. Gazzard G, Friedman DS, Devereux JG et al (2003) A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes. Ophthalmology 110:630–638

    Article  Google Scholar 

  19. Lee KS, Sung KR, Kang SY et al (2011) Residual anterior chamber angle closure in narrow-angle eyes following laser peripheral iridotomy: anterior segment optical coherence tomography quantitative study. Jpn J Ophthalmol 55:213–219

    Article  Google Scholar 

  20. Quigley HA (1981) Long-term follow-up of laser iridotomy. Ophthalmology 88:218–224

    Article  CAS  Google Scholar 

  21. Pollack IP (1981) Laser iridotomy in the treatment of angle-closure glaucoma. Ann Ophthalmol 13:549–550

    CAS  PubMed  Google Scholar 

  22. Friedman DS (2001) Who needs an iridotomy? Br J Ophthalmol 85:1019–1021

    Article  CAS  Google Scholar 

  23. How AC, Baskaran M, Kumar RS et al (2012) Changes in anterior segment morphology after laser peripheral iridotomy: an anterior segment optical coherence tomography study. Ophthalmology 119:1383–1387

    Article  Google Scholar 

  24. Lee RY, Kasuga T, Cui QN et al (2014) Association between baseline iris thickness and prophylactic laser peripheral iridotomy outcomes in primary angle-closure suspects. Ophthalmology 121:1194–1202

    Article  Google Scholar 

  25. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ (2002) The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 86:238–242

    Article  Google Scholar 

  26. Shaffer RN (1960) Primary glaucomas. Gonioscopy, ophthalmoscopy and perimetry. Trans Am Acad Ophthalmol Otolaryngol 64:112–127

    CAS  PubMed  Google Scholar 

  27. Liu S, Li H, Dorairaj S et al (2010) Assessment of scleral spur visibility with anterior segment optical coherence tomography. J Glaucoma 19:132–135

    Article  Google Scholar 

  28. Mak H, Xu G, Leung CK-S (2013) Imaging the iris with swept-source optical coherence tomography: relationship between iris volume and primary angle closure. Ophthalmology 120:2517–2524

    Article  Google Scholar 

  29. Liu S, Yu M, Ye C et al (2011) Anterior chamber angle imaging with swept-source optical coherence tomography: an investigation on variability of angle measurement. Invest Ophthalmol Vis Sci 52:8598–8603

    Article  Google Scholar 

  30. Lee RY, Kasuga T, Cui QN et al (2013) Association between baseline angle width and induced angle opening following prophylactic laser peripheral iridotomy. Invest Ophthalmol Vis Sci 54:3763–3770

    Article  Google Scholar 

  31. Yoong Leong JC, O’Connor J, Soon Ang G, Wells AP (2014) Anterior segment optical coherence tomography changes to the anterior chamber angle in the short-term following laser peripheral iridoplasty. J Curr Glaucoma Pract 8:1–6

    Article  Google Scholar 

  32. Ang BCH, Nongpiur ME, Aung T et al (2016) Changes in Japanese eyes after laser peripheral iridotomy: an anterior segment optical coherence tomography study. Clin Exp Ophthalmol 44:159–165

    Article  Google Scholar 

  33. Ng WT, Morgan W (2012) Mechanisms and treatment of primary angle closure: a review. Clin Exp Ophthalmol 40:e218–e228

    Article  Google Scholar 

  34. He M, Lu Y, Liu X et al (2008) Histologic changes of the iris in the development of angle closure in Chinese eyes. J Glaucoma 17:386–392

    Article  Google Scholar 

  35. Oka N, Otori Y, Okada M et al (2006) Clinical study of anterior ocular segment topography in angle-closure glaucoma using the three-dimensional anterior segment analyzer Pentacam. Nippon Ganka Gakkai Zasshi 110(5):398–403

    PubMed  Google Scholar 

  36. Coakes RL, Lloyd-Jones D, Hitchings RA (1979) Anterior chamber volume. Its measurement and clinical application. Trans Ophthalmol Soc U K 99:78–81

    CAS  PubMed  Google Scholar 

  37. Dorairaj S, Liebmann JM, Ritch R (2007) Quantitative evaluation of anterior segment parameters in the era of imaging. Trans Am Ophthalmol Soc 105:99–108 discussion 108–10

    PubMed  PubMed Central  Google Scholar 

  38. Radhakrishnan S, Goldsmith J, Huang D et al (2005) Comparison of optical coherence tomography and ultrasound biomicroscopy for detection of narrow anterior chamber angles. Arch Ophthalmol 123:1053–1059

    Article  Google Scholar 

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Funding

We acknowledge support from the Initiative to Cure Glaucoma of the Eye and Ear Foundation of Pittsburgh; NIH CORE Grant P30 EY08098 to the Department of Ophthalmology, and from an unrestricted grant from Research to Prevent Blindness, NY, NY.

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Authors and Affiliations

  1. Department of Ophthalmology, School of Medicine, University of Pittsburgh, 203 Lothrop St., Pittsburgh, PA, 15213, USA

    Hamed Esfandiari & Nils A Loewen

  2. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Hamed Esfandiari, Nassim Amouhashemi & Pooya Torkian

  3. Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Pakravan

  4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

  5. Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Khosrow Jadidi

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  1. Hamed Esfandiari
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  2. Mohammad Pakravan
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  3. Nassim Amouhashemi
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  4. Mehdi Yaseri
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  7. Nils A Loewen
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Corresponding author

Correspondence to Nils A Loewen.

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Conflict of interest

NAL has received honoraria for Trabectome wet labs and lectures from Neomedix Corp.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written consent form was received from all participants in this study.

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Esfandiari, H., Pakravan, M., Amouhashemi, N. et al. Low iris and anterior chamber volume is associated with deepening after laser peripheral iridotomy in primary angle closure suspects. Graefes Arch Clin Exp Ophthalmol 256, 2173–2179 (2018). https://doi.org/10.1007/s00417-018-4092-8

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  • DOI: https://doi.org/10.1007/s00417-018-4092-8

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